HMSA
Provider Services Coordinator
HMSA, Honolulu, Hawaii, United States, 96814
Interact with providers and inter-departmental representatives in a professional, knowledgeable, and timely manner to provide accurate coordination and resolution of inquiries received via phone, email, fax, and mail regarding provider programs, campaigns, initiatives, incentives, etc.
Resolve routine concerns and use probing questions to gather information needed to escalate more complex issues for further research and resolution. Track receipt and resolution of and research and respond to Tier 1 provider inquiries and escalate Tier 2 inquiries per established workflows and processes. Follow up on open inquiries that have been referred to others.
Answer incoming inquiries by accessing and interpreting data in various computer systems. Provide customers with a high level of service in a business-like and professional manner while conducting appropriate research to resolve inquiries in a timely manner.
Use resources (Sapphire, Koogle, FAQs, PRC, etc.) to resolve inquiries and reach out to other units when additional assistance is needed.
Coordinate and track providers joining and terminating from HMSA's value-based programs (i.e., Payment Transformation).
Assist Provider Services staff with attribution and payment inquiries. Work entails use of the Microstrategy database, QNXT database, and Coreo/Cozeva platforms to determine attribution logic: determine how multiple members were added/removed from provider patient panels; determine member plan status; and determine if a provider was paid a PMPM for member. Payment inquiry assistance to confirm the status of provider checks.
Perform various administrative tasks to support Provider Services including but not limited to receiving and distributing incoming mail, ordering office supplies, filing, and photocopying as necessary, correspond to and track hard copy and electronic invites to seminar and webinar invitees/participants.
Provide logistical support for administrative and operational needs of the department, to include, but not limited to, coordinating department staff's access requests to HMSA locations and systems and tools via the AMU process; coordinating equipment procurement, installation, and moves; sending and receiving faxes; inputting RSVPs for events; reserving and lending A/V equipment.
Perform member and provider outreach via phone, email, fax, and mail in support of department and corporate campaigns and special projects.
Create and maintain electronic files to track inquiries and outreach; data enter information regarding inquiries into tracking application.
Assist manager with creation, review, and modification of workflows and processes and training of new hires.
Performs other duties as assigned.
Complete assignments related to project work as directed by management.
Cooperate with superiors and peers in activities that support/accomplish corporate values.
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Resolve routine concerns and use probing questions to gather information needed to escalate more complex issues for further research and resolution. Track receipt and resolution of and research and respond to Tier 1 provider inquiries and escalate Tier 2 inquiries per established workflows and processes. Follow up on open inquiries that have been referred to others.
Answer incoming inquiries by accessing and interpreting data in various computer systems. Provide customers with a high level of service in a business-like and professional manner while conducting appropriate research to resolve inquiries in a timely manner.
Use resources (Sapphire, Koogle, FAQs, PRC, etc.) to resolve inquiries and reach out to other units when additional assistance is needed.
Coordinate and track providers joining and terminating from HMSA's value-based programs (i.e., Payment Transformation).
Assist Provider Services staff with attribution and payment inquiries. Work entails use of the Microstrategy database, QNXT database, and Coreo/Cozeva platforms to determine attribution logic: determine how multiple members were added/removed from provider patient panels; determine member plan status; and determine if a provider was paid a PMPM for member. Payment inquiry assistance to confirm the status of provider checks.
Perform various administrative tasks to support Provider Services including but not limited to receiving and distributing incoming mail, ordering office supplies, filing, and photocopying as necessary, correspond to and track hard copy and electronic invites to seminar and webinar invitees/participants.
Provide logistical support for administrative and operational needs of the department, to include, but not limited to, coordinating department staff's access requests to HMSA locations and systems and tools via the AMU process; coordinating equipment procurement, installation, and moves; sending and receiving faxes; inputting RSVPs for events; reserving and lending A/V equipment.
Perform member and provider outreach via phone, email, fax, and mail in support of department and corporate campaigns and special projects.
Create and maintain electronic files to track inquiries and outreach; data enter information regarding inquiries into tracking application.
Assist manager with creation, review, and modification of workflows and processes and training of new hires.
Performs other duties as assigned.
Complete assignments related to project work as directed by management.
Cooperate with superiors and peers in activities that support/accomplish corporate values.
#LI-Hybrid
#J-18808-Ljbffr